Blood tests to rule out other causes of hair loss, other than Male Pattern Baldness? 26, Male

Thank you for your question. I understand you’re 26-years-old and you’d like to know if there are blood tests that could help determine other causes of hair loss aside from male pattern hair loss.

I think I can certainly help you with this question, as hair loss treatment has been a big part of my practice, particularly in the area of non-surgical hair loss. To give you a little about my background — I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I’ve also been performing hair transplants for that same amount of time.

In our practice when a patient like yourself comes in with hair loss concerns, we look at their family history on both the mother’s and father’s side of the family, and by doing this, we’ve been able to establish some degree of a hair loss pattern within the family. Now, it’s important to understand that hair loss is associated with a genetic roll of the dice, particularly since there are 11 chromosomes that are linked to hair loss. This means that pattern hair loss can be sporadic and variable; in some cases it can manifest, and in other cases it won’t.

As part of the evaluation, we also look at general medical health. There are certain blood tests that are routinely performed as part of a general physical examination for men, and that includes taking vitamin D levels. Vitamin D plays an important role in maximizing hair quality, and because it is common see a decrease in vitamin D levels, we always require patients to take vitamin D.

For most men, we examine the scalp with a microscope to establish if there is pattern loss or hair thinning. Hair thinning, where normal hair progressively becomes thinner and thinner until it disappears, is very typical of androgenetic alopecia. To my knowledge, there is no genetic or nutritional deficiency that creates this type of pattern. I have no qualms about supplementary nutrition to improve overall hair health, whether it is in the form of multivitamins or Omega-3 acids. However, when you see that even people with nutritional deficiencies and less than ideal living circumstances can have a full head of hair, you need to question whether it really is an issue of nutrition or an issue of genetics. Many people also think hair loss could be hormone-related and they will try to see an endocrinologist for advice, which there is no harm in doing. I would have to say that from my experience, 95% of hair loss is genetic pattern hair loss.

In our practice, we use a treatment called Hair Regeneration to help people with pattern hair loss. Hair Regeneration makes use of a combination of platelet-rich plasma and Acellular matrix delivered via an injection into the scalp. There is no surgery involved, and usually only one Hair Regeneration session is needed. The treatment is able to stop the progression of hair loss, reverse the thinning process so that existing thinning hair becomes thicker, and reactivates the growth cycle of existing hair follicles in the scalp. It is a remarkable treatment that has shown a 99% success rate for both male and female pattern hair loss. In fact, it has been so successful that people from all over the world come to our offices just to receive this single treatment. We’ve also started a company called TrichoStem™ Hair Regeneration to allow us to give more people access to this type of regenerative treatment outside our main New York offices.

Going back to your question, you can look at thyroid hormones, iron levels, liver function, and hormonal levels, in addition to having a blood test. Most of the time, people come to us after they have exhausted everything else. They will have all the above tests already done, and some will even get a rheumatologic and autoimmune workup, just so they can be absolutely sure they have ruled out everything else that could possibly lead to hair loss.

Women, on the other hand, have more sensitivity to variations in hormone levels. For example, some women report experiencing hair loss after starting a birth control pill, stopping a birth control pill, pregnancy, delivery, etc. There are more issues that need to be taken into consideration when treating women. With men, once male pattern hair loss is diagnosed, treatment options usually range from topical drugs such as finasteride and minoxidil to hair transplants, though many patients choose to go with Hair Regeneration due to the straightforwardness of the treatment. I think it would be beneficial for you to look into Hair Regeneration treatment, or other similar treatments.

I hope that was helpful and I wish you the best of luck!

This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

The following is  a list of lab work to detect causes of hair loss.  It is important to realize that even though hair loss can be categorized as androgenetic alopecia, there are causes that can speed up hair loss significantly and a complete examination including history of hair loss, a physical examination, and lab work can be very useful. 

With lab work you want a routing set of blood work to rule out anemia, a complete metabolic panel to rule out electrolyte abnormalities.  You can obtain Free testosterone, total testosterone and DHT but this is useful if you plan to follow it serially and/or you are starting a regimen that alters the levels of those hormones.   Many supplement can increase free testosterone by displacing it off of SBGH and can easily be detected.  

There are other lab works needed on a case by case basis including biopsies if need be.  Every patient needs to be evaluated and utility of labs assessed on a case by case basis. 
f

A doctor does not need a blood test to diagnose genetic hair loss in a man which is characteristic to have miniaturization in a pattern that is followed by balding.  99% of me with hair loss have genetic balding

The only way to fully test for hair loss is scalp biopsies.  I suggest two and suggest they be reviewed in both horizontal and vertical sections. This is IF you do not trust your hair loss expert physician.  Best, Dr. Emer.

You're wise to always think other causes of hair loss. However, keep in mind that many causes of hair loss have normal blood tests. So one can not rely on blood tests to diagnose hair loss.

But typical tests to assess for telogen effluvium include ferritin, TSH, and a complete blood count (CBC). But there dozens of others too depending on the patient's history.

If you have scarring alopecia, alopecia areata, traction alopecia or a few others, bkood tests are tylically normal.